How to treat genitourinary syndrome of menopause with local estrogen

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  • Опубліковано 22 лис 2024

КОМЕНТАРІ • 123

  • @heatherhirschMD
    @heatherhirschMD  3 роки тому +10

    What did you try and what did you find success with? Are you interested in my review on over the counter options? Happy Monday!

    • @zaltanmula3111
      @zaltanmula3111 2 роки тому

      Who thought I would be free from hirsutism Dr iyaremoses on UA-cam did help me get rid of hyperthyroidism with herbs medications.

    • @susanjane8550
      @susanjane8550 2 роки тому

      I was facing hirsutism, I suffered until I meet Dr iyaremoses on UA-cam, who cured me from it for more information you can reach him out on UA-cam

    • @hiwetberhe3001
      @hiwetberhe3001 Рік тому

      Thank you for teaching this it is important for me. I have asked my GYN she said it is not good that i might get cancer. what is the over the counter option?

  • @karlakolb4712
    @karlakolb4712 3 роки тому +20

    Great video! Concise and informative. Thank you for helping educate women. I had a hysterectomy and went into surgical menopause. I had no idea what was happening when I saw my lady parts shrinking and developed chronic UTI's. I was not informed pre surgery by my doctor. A lot of my pain could have been avoided. I am now using compounded vaginal and topical estrogen along with testosterone and finally seeing improvements. Our young girls need to be educated about GSM in health ed in school. It's a part of life! Most women I encounter have never heard of it and don't know it is a part of perimenopause and menopause. They really don't know what is happening to their bodies. I didn't!

    • @christinelamb1167
      @christinelamb1167 3 місяці тому

      I didn't have a hysterectomy, but I went into natural menopause 4 years ago. I'm now 60 , and having severe GSM! My "parts" hurt all the time, it's so dry and I sometimes have stabbing and burning sensations. I've been celibate for over 8 years, but even if I wanted to have a relationship, there's no possible way I could have sex!
      Recently my pain has gotten worse, and the doctor told me today I have a urethral caruncle (basically it's a benign, but painful, growth on one side of the urethral opening). She prescribed Estrace cream, so I'm starting that tonight. I tried it before a few years ago and it didn't seem to do much. But I only used it for a few weeks, so maybe I need to use it longer to see benefits.
      I also had no idea going into menopause what was going to happen to me! It's been quite a shock. I knew about hot flashes, but I had no idea my vagina and vulva were going to shrink up and wither away! This is just terrible, and devastating. I wish I had been more prepared on what to expect!

  • @DzDani
    @DzDani Рік тому +9

    Thank you for all that you do! Its so frustrating to me that the entire healthcare system has very little education on this subject. We have to turn to UA-cam for help!

  • @veganangel68
    @veganangel68 3 роки тому +8

    I have a grade 1 uterine prolapse and the E-string just kept falling out. The estradiol cream works great for me. I buy multipacks of disposable applicators with measurements. You only need 1 gram, not a full applicator so it's not messy at all, just use a panty liner.

  • @jenifad9959
    @jenifad9959 Рік тому +3

    I wish I could find someone like you Dr Hirsch in my area.

    • @AquaFrost777
      @AquaFrost777 10 місяців тому +1

      Same! One flawed study ruined our ability to get rx for estrogen forever!

  • @paulinesmith6553
    @paulinesmith6553 3 роки тому +4

    I suffered from severe hot flashes for over ten years and I finally got an RX for estradiol and I absolutely cannot believe how well this had worked. I go to a local VA hospital for my care and they are clueless on women’s care. I originally had an RX for Premarin but there is none to be found from the manufacturer they tell me. I tried Premarin a few years ago for a short time but I kept getting BV. I’m hoping this works to help my PH get to normal levels.

  • @jh9912
    @jh9912 Рік тому +4

    Do you have a video on DHEA?

  • @communityservicesnetworksd2370
    @communityservicesnetworksd2370 5 місяців тому +2

    Great video. Thanks.
    I am 4 months into HRT and have just used the cream. It is messy.
    My issue is urinary urgency. I hate the panty pads.
    What system do you think is best for urinary issues?

  • @Mebbe308
    @Mebbe308 Рік тому +2

    I’m using Vaginal oestrogen. Just recovering from a abscess in the vaginal area. So terribly painful. Taking antibiotics. I’m hopeful the oestrogen helps. Thanks so much from Mary in England

    • @christinelamb1167
      @christinelamb1167 3 місяці тому

      I found out today I have a urethral caruncle. It's so painful! The doctor prescribed estradiol cream, to be applied around the urethra and vulva area. I hope it works, because I'm tired of hurting "down there" all the time.

  • @patriciapyper4617
    @patriciapyper4617 Рік тому +2

    What is the best cream for post menopause does it help with urine leakage please thank you ♥️

  • @EliseRoseCrochet
    @EliseRoseCrochet Рік тому

    Thank you, thank you, thank you. I appreciate you being willing to share your knowledge with others. You've given me hope and confidence that my symptoms can improve, it won't be cost prohibitive and it's safe to use!! 🙏🏻

  • @kathryngeen1447
    @kathryngeen1447 11 місяців тому

    This is valuable information! Unfortunately, my gyn is very reluctant to give me much of it because my mom had breast cancer. I can’t believe how much women suffer needless after menopause because we don’t have a clear protocol for prescribing estrogen. It would alleviate so many urinary and bladder issues as well as vaginal dryness and atrophy (which is not just an intimacy issue!). My dilemma is finding a gyn who is willing to consider more aggressive prescription of estrogen given my family history.

    • @Blueskies1180
      @Blueskies1180 10 місяців тому

      From what I understand, local estrogen to the vagina does not increase your chances of breast cancer.
      You can take the research papers to your gyno and “teach” her/him that she doesn’t have to deny you treatment based on the research.

  • @elizabethgray2386
    @elizabethgray2386 2 місяці тому

    Thank you. Your video helped me have a conversation with my doctor about vaginal estrogen cream and my frequent nighttime urination. About a month in and only getting up once or twice a night. I was up 6-7 times.

  • @nicolemassey215
    @nicolemassey215 9 місяців тому +1

    Could the creams cause a yeast infection?

  • @debholbrook6060
    @debholbrook6060 3 роки тому +5

    OMG, thank you for this! I’ve been using Premarin since November and it has been huge blessing to me. And I’m glad to hear that you recommend it for the vestibule - that is currently my last remaining painful area and I have started dabbing the Premarin there a little more often. I’m alternating with hyaluronic acid because I’m finding that to be very soothing.

    • @sylviaking8866
      @sylviaking8866 2 роки тому

      Hey thanks for that tip.

    • @graciequiroz7443
      @graciequiroz7443 Рік тому

      What hylaronic acid do you use where can I find it?

    • @dupeit007
      @dupeit007 Рік тому

      ​@@graciequiroz7443please share the hyaluronic acid you use it might help others too. Thank you !

  • @Foofie2005
    @Foofie2005 3 роки тому +2

    Your channel amazing 🤩 You have helped me So Much! Thanks 🙏

    • @heatherhirschMD
      @heatherhirschMD  3 роки тому +1

      Awesome thank you!

    • @Foofie2005
      @Foofie2005 3 роки тому +1

      @@heatherhirschMD I truly mean what I said! Not feeling alone in the struggle to get back a healthy relationship with your partner and yourself is priceless. You’re a star 🌟 in my book! Thx Dr. Hirsch you rock 🙌🏼

  • @Lynn22823
    @Lynn22823 3 роки тому +3

    Ive heard if u have your cervix you suppose to take progesterone too..I wonder if its safe to use only the estradiol vaginal crwam I do not want to take HRT had bad side effects but just the estradiol cream is what helped me for my UTIs

  • @southernsass7624
    @southernsass7624 3 роки тому +3

    With the coconut oil in the one product , could it cause you to have a yeast infection?

    • @zaltanmula3111
      @zaltanmula3111 2 роки тому

      Who thought I would be free from hirsutism Dr iyaremoses on UA-cam did help me get rid of hyperthyroidism with herbs medications.

  • @K-qj5ou
    @K-qj5ou 7 місяців тому

    Will Vagifem tablet then help with vulva burning/dryness then or should I use the cream? Thank you.

  • @michelethompson7300
    @michelethompson7300 7 місяців тому

    Need to try something else. Been on topical estradiol and tesosterone cream and burning is bad as ever. Was thinking about E String. It's terribly expensive. Was thinking about E STring.

  • @drsm5649
    @drsm5649 3 роки тому +1

    Very informative! Do you have any insight as to which, if any, of these products are covered by insurance? And Would you be able to list or link these products with the correct names? Thank you so much!

    • @zaltanmula3111
      @zaltanmula3111 2 роки тому

      Who thought I would be free from hirsutism Dr iyaremoses on UA-cam did help me get rid of hyperthyroidism with herbs medications.

    • @amorafaith101
      @amorafaith101 2 роки тому

      I was facing hirsutism, I suffered until I meet Dr iyaremoses on UA-cam, who cured me from it for more information you can reach him out on UA-cam..

    • @amorafaith101
      @amorafaith101 2 роки тому

      I was facing hirsutism, I suffered until I meet Dr iyaremoses on UA-cam, who cured me from it for more information you can reach him out on UA-cam..

  • @joycebezanson4543
    @joycebezanson4543 Рік тому +1

    When you take vagifem if you insert it lower will that help more with the driness?

  • @zorymack3357
    @zorymack3357 Рік тому +1

    I followed your advice. I have a history of breast cancer. I use estradiol 3 times a week. Why do I get really bad breast tenderness?

    • @denisedito3129
      @denisedito3129 Рік тому

      Thats a symptom of to much estrogen

    • @Nameless351
      @Nameless351 Місяць тому

      Usually twice a week is the dose. Ask your fixture if you can cut back from three times a week to twice a week, to see if that breast tenderness side effect goes away or becomes less bothersome.

  • @sandralee6848
    @sandralee6848 3 роки тому

    Very informative! thanks

  • @annie.bo.briggs
    @annie.bo.briggs Рік тому

    Doctors conflict on whether there is systemic absorption. I hope there is.

  • @wigwenchontheroad874
    @wigwenchontheroad874 2 роки тому +1

    I have a question I can’t find the answer too so maybe you could ?
    I have just started taking estradiol Vaginal inserts 10 mcg twice a week
    I am experiencing spotting and cramps like a period is this normal in the beginning ?????

  • @kimporterfield5996
    @kimporterfield5996 3 роки тому +4

    I am a onset menopause breast cancer patient with NED after bilateral mastectomy. My oncologist will allow my gynecologist to give me estriol + testosterone so long as my bloodwork shows estradiol 36 or lower. We keep tweaking the Rx because it once was 140, then 41 on 2 doses a week. I insert it vaginally. Is that the wrong way to use it? Also how do we explain the increase in estradiol if it is not systemic? Thank you in advance

  • @pennygrow4848
    @pennygrow4848 5 місяців тому

    Thank you !

  • @PIA-tj5hc
    @PIA-tj5hc 3 роки тому +1

    Started Imvxxy about 3 weeks ago. So far so good, there is minimal mess like u have with creams & V almost feel back to normal. I did have some bleeding/spotting so I do twice a week

  • @joycebezanson4543
    @joycebezanson4543 Рік тому

    Can you alternate vagfem one time and the next time that week i use Replen s? Thank you

  • @tammys8547
    @tammys8547 2 роки тому

    Just curious if lack of estrogen cream/untreated GSM can result in blood clots in urine as a symptom. Thank you.

  • @patriciapyper4617
    @patriciapyper4617 Рік тому

    What if you have a bleed please thank s ♥️

  • @terrim.2244
    @terrim.2244 3 роки тому +1

    Are some of the treatments you discussed more or less likely to cause blood pressure issues? I tried yuvafem but it raised my blood pressure for 24-48 hours after every insert

  • @mskim4552
    @mskim4552 2 роки тому +1

    Hello Dr. I understand that all women are different in terms of menopause and perimenopause. I’ve never had a full term birth, are you seeing anything different with women like me who are in perim/menopause?

    • @soyicasweet99
      @soyicasweet99 2 роки тому

      Good question . I haven’t given birth either and in Peri and almost 46

  • @AnneS508
    @AnneS508 2 роки тому +1

    Thank you so much for this! My family physician told me I need to use progesterone if using vagifem more than twice a week. I asked for a consult to a gynecologist. She says I don't need progesterone and has increased me to daily use. I am getting mild cramping. Doesn't that mean it is getting into my system? I'm concerned and confused.

    • @soyicasweet99
      @soyicasweet99 2 роки тому

      Im getting cramping too. Using vaginal estrogen . I’m going to ease back from using it daily . I just started

    • @mdaze9753
      @mdaze9753 2 роки тому +1

      You only need to use progesterone if you are taking systemic estrogen and have a uterus. Vaginal estrogen is not systemic and does not require progesterone. The vaginal cramping could be your vaginal wall thickening or you could be sensitive to estrogen. Dr. Hirsch has another video you may be interested in called "Why to take progesterone at menopause"

  • @glennnorvell4693
    @glennnorvell4693 2 роки тому +1

    (Asking for my wife) Can you use the ring if you’ve had a hysterectomy? Thanks

  • @dgbenshabat3843
    @dgbenshabat3843 9 місяців тому

    What you recommend for breast cancer patients for vaginal dryness

  • @paulaventura1847
    @paulaventura1847 Рік тому

    I have a question that I can’t find any answers to
    If I’m on ERT cream but I still have painful sex and vaginal dryness can I also use a vaginal estrogen in addition to my transdermal estrogen?
    But I want the benefit of a systemic estrogen as far as preventing diseases

  • @theresab8525
    @theresab8525 Рік тому

    Hi, I'm 64, menopause started at 58/59. I have vaginal atrophy. October i had breakthrough bleeding. December I had an ablation done. My pcp norr obgyn want me to have HRT. What are your thoughts? Vaginal dryness is very painful with bleeding

  • @pamela5568
    @pamela5568 Рік тому

    Oh, and my gynecologist recommended Replens for vaginal dryness. I highly recommend it.

  • @emcgrath9129
    @emcgrath9129 3 роки тому +1

    I have been pronouncing Estring “est” ring, rhymes with best ring. I am a pharmacist. Am I pronouncing it wrong?

    • @heatherhirschMD
      @heatherhirschMD  3 роки тому

      funny You caught that! Keep calling it what you are I think I have my own way of saying it so I make sure I differentiate it from the femring and Estrace cream

  • @carmenhester9209
    @carmenhester9209 3 роки тому

    Thank you for your information. I have tried to use estrogens prescribed by my doctor but every time I use it, it turns my vaginal skin very sensitive, painful and swollen. What to do at that point.

    • @zaltanmula3111
      @zaltanmula3111 2 роки тому

      Who thought I would be free from hirsutism Dr iyaremoses on UA-cam did help me get rid of hyperthyroidism with herbs medications.

  • @chanellmorrisey4916
    @chanellmorrisey4916 2 роки тому +2

    I'm going through menopause and have noticed a lot of changes in my vaginal area, as well as experiencing frequent urination and urgency as well as burning, itching and dryness in my vagina. My OB-GYN prescribed Premarin cream fir me to use, but I don't like having to use the applicator as the cream doesn't always stay inside my vagina after insertion. The nurse recommended using my finger to apply it, but I'm not to fond of doing that. Is there some other form of medication that I can use to treat these symptoms or another brand?

    • @dfernandez5583
      @dfernandez5583 2 роки тому

      Vagifem has no mess at all, it's like a tiny pill that you insert using an applicator. Dr. Hirsh mentions Imvxxy that apparently doesn't have mess either.

  • @td6369
    @td6369 3 роки тому

    Dr Heather. What would be the solution for Stress incontinence and Vaginal Atrophy?? Have you heard of a device called EFEMIA it's placed vaginally to press the urethra alleviating leakage but I'm wondering how effective it really is??

  • @vickiteeples2232
    @vickiteeples2232 3 роки тому +1

    I am currently on Exemestane due to DCIS breast cancer. Do you have any suggestion for painful intercourse that doesn’t contain estrogen? I have had 2 Mona Lisa treatments without success.

    • @aleecewhite3919
      @aleecewhite3919 2 роки тому

      Research the options below, I am going to ask my medical and integrative team about them as well, I am at the end of bc treatmemt and in a similar situation as you:
      IntraRosaa
      Sea Buck Thorn Sibu oil
      Foria arousal and Awaken CBD Oil
      Hyaluronic Acid
      Vit E suppositories
      Carlson Labs Key E Suppositories
      Vaginal DHEA

    • @aleecewhite3919
      @aleecewhite3919 2 роки тому

      I was thinking about the Mona Lisa procedure but the reviews just dont seem worth it, perhaps it does help to an extent with overall vag tissue health but not painful intercourse

  • @jenniferwilson9579
    @jenniferwilson9579 3 роки тому +2

    Can you comment on Mona Lisa Touch vaginal treatment. It seems like a scam, but would love to hear your opinion.

  • @nm-xu2ik
    @nm-xu2ik 3 роки тому

    Love your videos!
    On E patch and oral nightly progesterone (postmenopausal). Can I use estradiol vaginal cream if I have a new ovarian cyst since it’s local to the vagina/ vulva?

    • @zaltanmula3111
      @zaltanmula3111 2 роки тому

      Who thought I would be free from hirsutism Dr iyaremoses on UA-cam did help me get rid of hyperthyroidism with herbs medications.

  • @lisaschwarz6961
    @lisaschwarz6961 3 роки тому +11

    What about sex? How does an active sex life influence my choice? Will estrogen damage my partner? Can I use lube? will any degrade sex toys or condoms? Can you address this please? Why skip such an important aspect? It further perpetuates the idea that we are no longer sexual beings.

    • @setonsimar9096
      @setonsimar9096 11 днів тому

      She spoke about it not affecting your partner in another video and using it only twice a week giving you freedom for sex if you feel it’s too messy other nights

  • @senseofwonder4734
    @senseofwonder4734 3 роки тому

    I had TVT procedure when I had a partial hysterectomy. I am 51, eat WFPB, very minimal caffeine occasionally, exercise at least every other day, have a BMI of 20 and still struggle with urgency. Would vaginal estrogen possibly help?

    • @karintatum7424
      @karintatum7424 3 роки тому

      LISA , what type of diet do you follow?

  • @lauried4439
    @lauried4439 2 роки тому

    I’ve been using generic estradiol vaginal cream .01% with good effect. I just found out that one of the inactive ingredients in the cream is hypromellose, which I beed to avoid. Can a weak strength compounded (to avoid this ingredient) estradiol cream be used in the vagina and remain locally in the vagina?

    • @zaltanmula3111
      @zaltanmula3111 2 роки тому

      Who thought I would be free from hirsutism Dr iyaremoses on UA-cam did help me get rid of hyperthyroidism with herbs medications.

  • @suzannemoses8015
    @suzannemoses8015 3 роки тому

    Hello, thank you for all of your information. It is so helpful. I am on HRT, Estradiol 1mg and progesterone 100 mg, test 1 ml cream. My question is this, can you use vaginal Estrogen as a compliment to other HRT? I still have issues with atrophy/ and all things discussed in this video. I have been on HRT for years with great success, but for this.

    • @kristieric3893
      @kristieric3893 2 роки тому

      I’m not a dr, but have experienced surgical menopause, starting 10 years ago. This confused me before I was told, but only the Estriol (NOT to be confused with estradiol. ESTRIOL is the vaginal estrogen that you can get in OTC Benzwecken suppositories or Mother’s Dose cream that goes on the vulva. Mothers dose prob has estrogen & estriol, so I’d make sure it is the “Estriol”. I suffered for almost 10 years with sudden dryness & constant UTI’s until I found ESTRIOL. This was my experience, so I’d discuss with your doctor of course about adding OTC or prescribed ESTRIOL.

    • @Blueskies1180
      @Blueskies1180 10 місяців тому

      You can also try non-hormonal suppositories for atrophy/dryness in addition to your HRT regimen.

    • @Blueskies1180
      @Blueskies1180 10 місяців тому

      You can also try non-hormonal suppositories for atrophy/dryness in addition to your HRT regimen.

  • @maryjoobrienmoulding6298
    @maryjoobrienmoulding6298 3 роки тому

    About 10 years ago I had a blood clot in my leg so my Gp doesn't want me to use estrogen my uro says it will help with UTI's probably I had a hysterectomy when I was 31 I'm 63 now. Its a scary dilemma for me what is your opionion on using estrogen I have used vaga-fem a few years ago. Thanks.

    • @karintatum7424
      @karintatum7424 3 роки тому +1

      What caused you to stop the Vagifem? 🤔

    • @maryjoobrienmoulding6298
      @maryjoobrienmoulding6298 3 роки тому

      @@karintatum7424 my GP who was my blood clot Dr. Also,doesnt want me to take any estrogen , estrogen can cause blood clots and once you have a clot you are prone to getting another. He did leave up to me but I havent took any estrogen since . Clots can kill you very fast. If i get another clot I'd be on warfarin the rest of my life so hard desisions. Even though they say topical estrgen goes very little system wide.. But my Dr. Says but if your that one so? Its all hard.

    • @heatherhirschMD
      @heatherhirschMD  3 роки тому +3

      Vagifem, or any local vaginal estrogen for GSM, is absolutely fine and does not increase the risk of blood clot, so you are OKAY to use it and IT WOULD HELP!

    • @maryjoobrienmoulding6298
      @maryjoobrienmoulding6298 3 роки тому +1

      @@heatherhirschMD yes I agree my Md just has huge doubts. Its hard.

  • @tonyascreativespace3067
    @tonyascreativespace3067 Рік тому

    but the box warns your abour cancer with cream. its right on the box in bold. letters. it a new box in my draw.

  • @janetayala-simmons6240
    @janetayala-simmons6240 3 роки тому

    I am factor 5 and can’t take any estrogen. Help!!

  • @carolbruno7731
    @carolbruno7731 2 роки тому

    Are they safe if you've already had endometrial stage 1 and hyserectomy? OBYN ONC saying no it's like fire on gasoline.

    • @heatherhirschMD
      @heatherhirschMD  2 роки тому +1

      Ask about imvexxy 4 ug ultra low but you need something!

    • @carolbruno7731
      @carolbruno7731 2 роки тому

      @@heatherhirschMD Awesome thank you I have my 1-1/2 year check up next week with Gyn Onc..will do.

    • @carolbruno7731
      @carolbruno7731 2 роки тому

      PS Love your videos very informative !!! ;)

    • @zaltanmula3111
      @zaltanmula3111 2 роки тому

      Who thought I would be free from hirsutism Dr iyaremoses on UA-cam did help me get rid of hyperthyroidism with herbs medications.

    • @amorafaith101
      @amorafaith101 2 роки тому

      I was facing hirsutism, I suffered until I meet Dr iyaremoses on UA-cam, who cured me from it for more information you can reach him out on UA-cam..

  • @ildus48
    @ildus48 2 роки тому

    I still not sure about vaginal estriol not being absorbed systematically.
    When you are prescribed transdermal estradiol your serum level goes up, so it is absorbed through the skin.
    The vagina has lots of nerve ending and little veins so i am sure that it also goes systematic.
    If as a postmenopausal women i would test before and after using estriol cream that would give me definet answer may be.
    When i use vaginal estriol my hot flashes are less, go figure it out!

  • @lalalalaaand
    @lalalalaaand Рік тому

    It said it could cause cancer of the womb

  • @marciasloan534
    @marciasloan534 7 місяців тому

    INTRAROSA ???

  • @j.a.1239
    @j.a.1239 3 роки тому +6

    Please don’t use Premarin. Research it. It’s a very cruel industry

    • @beachpony
      @beachpony Рік тому +2

      Couldn’t agree more. I can’t believe it’s still legal to do what they do to these poor horses! People don’t think about it, and what about the foals too? Most are shipped out to auction to slaughter. Horrible horrible horrible!

    • @meghoughton562
      @meghoughton562 Рік тому

      Are there any good alternatives?

    • @latingal3731
      @latingal3731 3 місяці тому

      ​@@meghoughton562use estriol cream ovestin

  • @doreenessihos6144
    @doreenessihos6144 29 днів тому

    You sound like a very aggressive doctor, not for me.